Professional Documents
Culture Documents
Dr.F.Bennani
DEFINITION OF CIRRHOSIS
Cirrhosis
End stage of any chronic liver disease. Characterized histologically by regenerative nodules surrounded by diffuse fibrous tissue
Note : Focal fibrosis in the liver is not cirrhosis e.g : healing of liver abcess
Inflammation
Fibrosis & Hepatocyte regeneration
Cirrhosis
Causes
Alcoholic liver disease Viral hepatitis Primary biliary cirrhosis Haemochromatosis others
Pathogenesis
Liver damage Replacement by fibrous tissue (fibrosis)
No fibrous tissue in normal liver What type of cells responsible for fibrosis
Fibrosis
Key event in Fibrosis is Stellate cell activation
In Normal Liver Stellate Cells store Vitamin A Activation leads to:
Loss of Vitamin A Proliferation Differentiation myofibroblasts Fibrogenic
Fibrosis
Activated HSC
Protein synthesis Collagen synthesis
Normal
Cirrhosis
Normal
Cirrhosis
Irregular surface
Nodules
Consequences of Cirrhosis
Impaired catabolic activity
breakdown of by-products of metabolism
E.g. conjugation & excretion of bilirubin jaundice
Disruption of microvasculature
Portal Hypertension
Antidiuretic Hormone
Ascites
Complications of cirrhosis
A.Portal hypertension: a.esophageal varices b.ascitis. c.splenomegaly B.Hypoproteinemia: a.coagulopathy --- bleeding b.hypoalbuminemia --- oedema c.low serum globulin ----- low immunity infection C.Hepatic encephalopathy :impaired metabolism of ammonia D.Hepatocellular carcinoma ( hepatoma ) high level of alpha-fetoprotein